Robert Marriott Medical Corp

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A92018 Issued in CA

Legal business name

ROBERT MARRIOTT MEDICAL CORP

Doing business as

Advantage Wound Care

Practice address

222 N Pacific Coast Hwy Ste 2175
El Segundo, CA 90245-5639

Phone

(877) 878-3289

Fax

(877) 817-3227

NPI assigned

Feb 25, 2008

Last updated

Jun 4, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert James Marriott, M.D.NPI 1700804887

Title

Owner/Ceo

Phone

(310) 402-6811

Specialties & licenses 2

Addresses

Other names 1

• Advantage Wound Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA, NJ, TX, NY, MD, DC, PA, WA, LA, ME, HI, AZ, CO, NH, NV, GA, NM, MI, MO, OK, AL, KS, TN23 enrollments

Enrollment records 23

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eobert Marriott Medical Corp

  • Surgery Physician
  • Friendswood, TX
  • NPI 1437600046

  O20090518000379

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Maywood, NJ
  • NPI 1003367558

  O20090203000117, O20150501001748

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Mount Airy, MD
  • NPI 1003367566

  O20110916000010

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Beaumont, TX
  • NPI 1073064689

  O20090518000379, O20110623000129, O20130104000175

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Lafayette, LA
  • NPI 1093266553

  O20121023000597

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Mesquite, TX
  • NPI 1164973012

  O20090518000379

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • San Antonio, TX
  • NPI 1356892962

  O20090518000379

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Warrington, PA
  • NPI 1467903914

  O20120521000580

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Fort Worth, TX
  • NPI 1518418128

  O20090518000379

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Austin, TX
  • NPI 1568913010

  O20090518000379

  Same enrollment
• Robert Marriott Medical Corp

  • Surgery Physician
  • Clute, TX
  • NPI 1619428562

  O20090518000379

  Same enrollment

Locations (25 of 189)

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Congregational Homes

  dba Mt San Antonio Gardens

  • Skilled Nursing Facility
  • Pomona, CA
  • NPI 1609859461

  Adp of the SNF, Limited Partnership Interest, Operational/Managerial Control

  CMS ownership

Practitioners 329

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Andrade

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1295248920

  ME, NH

  Medicare reassignment Care Compare group NPD
• Eaman Balouch, MD PHD

  • General Practice Physician
  • El Segundo, CA
  • NPI 1265884498

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Junife Palaganas Burguillos, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Sacramento, CA
  • NPI 1992945901
  Medicare reassignment Care Compare group NPD
• Gonzalo Cruz-Schiavone, M.D.

  • Surgery Physician
  • El Segundo, CA
  • NPI 1578953485

  AZ, NV

  Medicare reassignment Care Compare group NPD
• Kimberly Cuenca, NP

  • Family Nurse Practitioner
  • El Segundo, CA
  • NPI 1568213270

  LA

  Medicare reassignment Care Compare group NPD
• Thinh Dang, DPM

  • Podiatrist
  • El Segundo, CA
  • NPI 1619618725
  Medicare reassignment Care Compare group NPD
• Adnan Mohammad Din, M.D.

  • Surgery Physician
  • Davis, CA
  • NPI 1851350839
  Medicare reassignment Care Compare group NPD
• Neilda Erickson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Santa Monica, CA
  • NPI 1548993181

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Niyayesh Gorjikia, DPM

  • Podiatrist
  • San Francisco, CA
  • NPI 1376121343
  Medicare reassignment Care Compare group NPD
• Stuart J Gourlay, MD

  • Surgery Physician
  • Pinole, CA
  • NPI 1346374378
  Medicare reassignment Care Compare group NPD
• Jose Joaquin Estalilla Hernandez, MD

  • Occupational Medicine Physician
  • Bakersfield, CA
  • NPI 1316311509

  Surgery

  Medicare reassignment Care Compare group NPD
• Jeremy W Jordan, PA

  • Physician Assistant
  • Riverside, CA
  • NPI 1487378949

  CO

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1083883938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 2175",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455639",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 2175",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455639",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 W Essex St",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "NJ",
            "postal_code": "076071023",
            "country_code": "US",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1340 E Fillmore St",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076433",
            "country_code": "US",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROBERT MARRIOTT MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "MARRIOTT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "310-402-6811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A92018",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A92018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Wound Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advantage Wound Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonia Rizvi
• Jocelyn Maria Roa
• Felicity Roach
• Melanie Robbins
• Kedine Roberson
• Robert Murphy DDS Apdc
• Aily Robert
• Bo Dean Robertson
• Camrynn Robertson
• Daysia Robertson

• Surgery Physician in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.